Who Needs to “Hit Rock Bottom”?

We are almost positive you have heard someone say “he won’t change until he hits bottom.” Have you ever thought deeply about what is being conveyed in that statement? Slang for as bad as it gets, “hitting bottom” usually refers to the need to reach a place (or state of being)

​where one is so desperate about how bad things are that you simply “have to” change.

On one hand there is a lot of sense in this idea, as it really describes one of the ways people get motivated toward change. “I finally got sick of waking up hung over all the time with my wife mad at me… it just wasn’t worth it anymore, so I’m getting some help.” Deciding that the costs outweigh the benefits is the primary reason people change.

On the other hand, our beliefs about substance abuse and compulsive behavior problems—and the potential for change—are built into the words we use to speak about them. The the statement “he needs to hit rock bottom” conveys a variety of problematic, deeply held culturally ingrained beliefs and attitudes and there are huge downsides to using it as a way to describe what needs to happen in order to change behavior.
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First, it promotes a belief that the change process cannot start until bottom is reached. It also implies that people won’t change unless they are “punished enough” by their own behavior that they see the light. Both of these assumptions could not be further from the truth and they have contributed to many treatment providers sending patients away and telling them to “come back when you’re ready.” It’s also contributed to family members and friends feeling like their only option is to step aside and watch their loved one suffer. Many opportunities for change and lives have been lost due to this flawed belief and culturally loaded statement.

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